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Impac o Female Geni al Mu ila ion (FGM) on sexual heal h: A comp ehensi e
in e disciplina y e iew
Oghogho.P. Izeko 1, *, Oyindamola Fagbo e 1, Chinemelum Uzochukwu 1 and Sybil. O. T E iaka 2
1 Depa men o Obs e ics and Gymaecology, Bi mingham Hea lands Hospi al. UK.
2 Long iew Medical Cen e, Huy on, Li e pool UK.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(02), 2930-2949
Publica ion his o y: Recei ed on 07 Ap il 2025; e ised on 19 May 2025; accep ed on 21 May 2025
A icle DOI: h ps://doi.o g/10.30574/wja .2025.26.2.2004
Abs ac
Female Geni al Mu ila ion (FGM) emains a c i ical global heal h and human igh s issue, wi h mo e han 200 million
women and gi ls a ec ed wo ldwide. Despi e inc eased awa eness and in e na ional e o s o e adica e he p ac ice,
FGM pe sis s ac oss a ious cul u al and geog aphic con ex s, pa icula ly in pa s o A ica, he Middle Eas , and Asia.
This e iew examines he mul i ace ed impac o FGM on emale sexual heal h, d awing om clinical, psychological, and
sociocul u al pe spec i es o p o ide a comp ehensi e analysis o i s consequences. FGM encompasses a ange o
p ocedu es in ol ing pa ial o o al emo al o ex e nal emale geni alia o inju y o he emale geni al o gans o non-
medical easons. The p ac ice has p o ound and las ing implica ions on sexual unc ion, including diminished libido,
dyspa eunia (pain du ing in e cou se), ano gasmia, and educed geni al sensi i i y. These ou comes s em om bo h
ana omical al e a ions and psychological auma, leading o a complex in e play o physical and emo ional dys unc ion.
Fu he , FGM is associa ed wi h complica ions such as ch onic in ec ions, sca ing, and obs e ic auma, which
exace ba e sexual discom o and ep oduc i e challenges. Psychologically, women wi h FGM may expe ience anxie y,
dep ession, body image diso de s, and pos - auma ic s ess, all o which u he impai sexual well-being. Cul u al
aboos and s igma su ounding sexuali y o en silence a ec ed women, impeding access o medical and psychological
suppo . This e iew highligh s he u gen need o cul u ally sensi i e heal hca e se ices, auma-in o med
counselling, and legal amewo ks o suppo su i o s. I also emphasizes he impo ance o comp ehensi e sex
educa ion and communi y-d i en ad ocacy o comba FGM. Add essing he sexual heal h epe cussions o FGM is
essen ial o p omo ing bodily au onomy, gende equi y, and holis ic well-being.
Keywo ds: Female Geni al Mu ila ion; Sexual Dys unc ion; Women’s Heal h; Psychological T auma; Rep oduc i e
Righ s; Dyspa eunia
1. In oduc ion
1.1. Backg ound and Global Bu den o FGM
Female Geni al Mu ila ion (FGM) cons i u es a g a e iola ion o human igh s and a signi ican public heal h conce n
a ec ing millions o women and gi ls wo ldwide. De ined as all p ocedu es in ol ing he pa ial o o al emo al o
ex e nal emale geni alia o o he inju y o he emale geni al o gans o non-medical easons, FGM is deeply oo ed in
cul u al, eligious, and social no ms [1]. Despi e in e na ional ad ocacy and legal e o ms, FGM emains p e alen in a
leas 30 coun ies, p ima ily in A ica, he Middle Eas , and pa s o Asia, wi h g owing e idence o i s p ac ice in
diaspo a communi ies ac oss Eu ope, No h Ame ica, and Aus alia [2].
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Acco ding o UNICEF, o e 200 million women and gi ls ali e oday ha e unde gone FGM, wi h an es ima ed 3 million
gi ls a isk annually [3]. The p ac ice is ypically pe o med on mino s, o en unde unsani a y condi ions and wi hou
anes hesia, inc easing he isk o immedia e complica ions such as hemo hage, in ec ion, and e en dea h [4]. Long-
e m consequences include ch onic pel ic in ec ions, childbi h complica ions, and psychological auma.
FGM also ein o ces gende inequali y by con olling emale sexuali y and pe pe ua ing male dominance wi hin
pa ia chal s uc u es [5]. Despi e g owing esis ance om ac i is s, su i o s, and global heal h o ganiza ions, deeply
embedded adi ions con inue o sus ain he p ac ice in many communi ies. Comp ehensi e e o s in ol ing educa ion,
legal en o cemen , and heal h sys em e o m a e essen ial o e adica e FGM and mi iga e i s ex ensi e ha m [6].
1.2. WHO Classi ica ion and Typology o FGM
The Wo ld Heal h O ganiza ion (WHO) classi ies FGM in o ou dis inc ypes based on he ex en and na u e o he
geni al al e a ions. Type I in ol es he pa ial o o al emo al o he cli o is and/o he p epuce, known as
cli o idec omy. Type II, e e s o he pa ial o o al emo al o he cli o is and he labia mino a, wi h o wi hou excision
o he labia majo a [7].
Type III, he mos se e e o m, is e med in ibula ion. I in ol es na owing o he aginal opening by c ea ing a co e ing
seal o med by cu ing and eposi ioning he labia, some imes including emo al o he cli o is. Type IV includes all
o he ha m ul p ocedu es o he emale geni alia o non-medical pu poses, such as p icking, pie cing, incising, sc aping,
o cau e izing [8].
Each ype p esen s a ying deg ees o heal h isk and long- e m sexual dys unc ion. Unde s anding his ypology is
c i ical o heal hca e p o ide s and esea che s when assessing clinical ou comes and ailo ing in e en ion s a egies
[9].
1.3. Ra ionale o Focusing on Sexual Heal h Ou comes
Al hough much o he esea ch on FGM has his o ically ocused on physical and obs e ic complica ions, he e is a
g owing ecogni ion o he signi ican oll i akes on women’s sexual heal h and psychosocial well-being. Su i o s o
FGM equen ly epo diminished sexual desi e, a ousal di icul ies, pain ul in e cou se, and an inabili y o achie e
o gasm—all o which can p o oundly impac quali y o li e and in ima e ela ionships [10].
Sexual dys unc ion esul ing om FGM is no me ely physiological bu also oo ed in psychological auma, ea , and
misin o ma ion p opaga ed h ough cul u al na a i es abou emale sexuali y [11]. Mo eo e , limi ed access o sexual
heal h educa ion and suppo se ices exace ba es he silence and s igma su ounding hese expe iences.
Focusing on sexual heal h ou comes no only alida es he li ed eali ies o su i o s bu also expands he amewo k
o unde s anding FGM’s mul idimensional impac . I aligns wi h global heal h goals ha emphasize comp ehensi e
sexual and ep oduc i e igh s as cen al o women's au onomy and digni y [12].
1.4. Objec i es and S uc u e o he Pape
This pape aims o explo e he sexual heal h consequences o FGM by analyzing a ailable clinical and psychosocial
e idence, wi h pa icula emphasis on su i o s ’li ed expe iences and access o suppo i e se ices. I seeks o b idge
he gap be ween biomedical indings and human igh s discou ses o p o ide a holis ic pe spec i e on FGM’s impac .
Following his in oduc ion, Sec ion 2 p o ides an o e iew o sexual dys unc ion associa ed wi h FGM. Sec ion 3
e iews clinical and quali a i e e idence, while Sec ion 4 discusses in e en ion s a egies and heal hca e challenges.
Sec ion 5 o e s ecommenda ions o esea ch, policy, and p ac ice o imp o e su i o -cen e ed ca e and p omo e
sexual heal h equi y [13].
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(02), 2930-2949
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Figu e 1 Global map showing p e alence o FGM by egion
2. His o ical, cul u al, and socie al dimensions o FGM
2.1. Cul u al and T adi ional Jus i ica ions
Female Geni al Mu ila ion (FGM) is sus ained by a complex web o cul u al, adi ional, and pseudo- eligious belie s ha
a y ac oss egions and communi ies. One o he mos equen ly ci ed jus i ica ions is i s pe cei ed alignmen wi h
eligious alues, al hough no majo eligious ex manda es o explici ly endo ses he p ac ice [5]. In many con ex s,
FGM is e oneously associa ed wi h Islamic eachings, despi e s ong condemna ion by a ious Islamic schola s and
eligious au ho i ies [6].
The p ac ice is also embedded in i es o passage ce emonies, ma king he ansi ion om gi lhood o womanhood.
Wi hin hese adi ions, FGM is o en celeb a ed h ough elabo a e communi y i uals and s o y elling, aming i as a
necessa y s ep owa d social accep ance and ma u i y [7]. As such, i is iewed no me ely as a medical ac bu as a
cul u al pe o mance ha ein o ces communal iden i y.
Fu he mo e, FGM is widely belie ed o p omo e cleanliness, eminini y, and aes he ic appeal. In se e al socie ies, uncu
emale geni alia a e pe cei ed as di y, shame ul, o masculine, and he ac o cu ing is amed as essen ial o hygiene
and beau y [8]. These belie s a e pe pe ua ed by olde women, midwi es, and communi y elde s, c ea ing a cycle o
gene a ional ansmission.
Despi e g owing awa eness campaigns, hese cul u al na a i es emain deeply en enched and esis an o change,
pa icula ly whe e educa ion and heal hca e in as uc u e a e limi ed [9]. Unde s anding hese jus i ica ions is
essen ial o de eloping cul u ally sensi i e in e en ions ha challenge ha m ul no ms while espec ing he
communi ies' need o iden i y and belonging [10].
2.2. Social No ms, Gende Roles, and Communi y P essu es
FGM ope a es wi hin a b oade amewo k o gende ed social no ms ha p io i ize emale chas i y, obedience, and
amily hono . In many communi ies, a gi l's i gini y and ideli y a e di ec ly linked o he geni al s a us, and FGM is
p omo ed as a me hod o con olling emale sexuali y and p ese ing mo al beha io [11]. This belie no only
diminishes women’s au onomy bu also ein o ces pa ia chal expec a ions abou women’s oles wi hin ma iage and
socie y.
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The social p essu e o con o m is immense. Gi ls and amilies who esis FGM isk os aciza ion, shame, and diminished
ma iage p ospec s. In se e al cul u es, uncu women a e conside ed impu e o un i o ma iage, educing hei alue
in he eyes o po en ial sui o s and unde mining he amily’s social s anding [12]. This connec ion be ween FGM and
ma iageabili y makes i a deeply gende ed ins i u ion, upheld no only by men bu also by women who ea social
exclusion.
Communi y hono is o en ci ed as jus i ica ion o con inuing he p ac ice. Families comply wi h FGM no ou o
pe sonal con ic ion bu due o he ea o epu a ional damage i seen as ansg essing adi ion [13]. This collec i e
en o cemen is compounded by silence and aboo su ounding sexual heal h discussions, making open dissen di icul .
Al hough some communi ies ha e begun o ques ion and abandon he p ac ice, change is o en une en and con es ed.
Pee p essu e, misin o ma ion, and gene a ional loyal y con inue o ein o ce adhe ence o FGM, especially in u al o
isola ed egions [14]. Add essing hese social dynamics equi es communi y-d i en s a egies ha engage local
in luence s, challenge ha m ul gende no ms, and c ea e sa e spaces o dialogue and esis ance [15].
2.3. Legal F amewo ks and Policy In e en ions
Table 1 Summa y o Na ional and In e na ional Laws on FGM
Coun y
An i-FGM Law (Yea
Enac ed)
Key Legal P o isions
Penal ies o
Viola ion
Ra i ied
In e na ional
T ea ies
Kenya
P ohibi ion o FGM
Ac (2011)
C iminalizes FGM, bans
medicaliza ion,
ex a e i o ial applica ion
Up o li e
imp isonmen and/o
ines
CEDAW, Mapu o
P o ocol, CRC
Egyp
Penal Code
Amendmen (2008,
2016)
C iminalizes all o ms o
FGM including medicalized
p ocedu es
5–15 yea s
imp isonmen o
p ac i ione s
CEDAW, CRC
Nige ia
Violence Agains
Pe sons (P ohibi ion)
Ac (2015)
P ohibi s FGM na ionwide,
o e ides s a e law
Up o 4 yea s
imp isonmen and/o
ines
CEDAW, Mapu o
P o ocol
Uni ed
Kingdom
FGM Ac (2003);
Se ious C ime Ac
(2015)
C iminalizes FGM, a el
o cu ing, ailu e o
p o ec child
Up o 14 yea s
imp isonmen
CEDAW, CRC
F ance
Penal Code A icles
222-9 o 222-10
Recognizes FGM as a o m
o iolence, ex a e i o ial
ju isdic ion
Up o 20 yea s
imp isonmen
CEDAW, CRC
Somalia
No na ional ban; some
egional laws
Legal ambigui y,
adi ional no ms
domina e
No consis en ly
en o ced
CRC ( a i ied);
CEDAW (no a i ied)
Uni ed
S a es
Fede al P ohibi ion
Ac (1996, e ised
2021)
C iminalizes FGM and
anspo o mino s o
cu ing
Up o 10 yea s
imp isonmen
CEDAW (no a i ied);
CRC (signed, no
a i ied)
Aus alia
S a e and e i o y
laws; Model C iminal
Code
P ohibi s FGM na ionally
and ab oad
7–21 yea s
imp isonmen
depending on
ju isdic ion
CEDAW, CRC
O e he pas wo decades, legal and policy measu es ha e played an inc easingly p ominen ole in global e o s o
comba FGM. Many coun ies whe e he p ac ice is p e alen ha e enac ed na ional laws c iminalizing FGM, o en
supplemen ed by penal ies o medicaliza ion and c oss-bo de cu ing [16]. Fo ins ance, Kenya, Egyp , and Bu kina
Faso ha e implemen ed explici c iminal p o isions wi h a ying deg ees o en o cemen [17].
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On he in e na ional le el, ins umen s such as he Con en ion on he Elimina ion o All Fo ms o Disc imina ion Agains
Women (CEDAW) and he Mapu o P o ocol explici ly condemn FGM and obliga e membe s a es o ake legisla i e and
p e en i e ac ion [18]. The Sus ainable De elopmen Goals (SDG 5.3) u he ein o ce he global manda e o elimina e
ha m ul p ac ices, including FGM, by 2030.
Howe e , signi ican gaps emain be ween law and p ac ice. In many coun ies, en o cemen is weak due o limi ed
esou ces, co up ion, o eluc ance among local au ho i ies who iew FGM as a cul u al issue a he han a legal one
[19]. Addi ionally, ic ims and wi nesses a e o en unwilling o epo due o ea o e alia ion o loyal y o communi y
membe s. Legal ambigui y also pe sis s in coun ies wi h plu alis ic legal sys ems whe e cus oma y law may con adic
s a u o y p o isions.
Diaspo a coun ies ha e in oduced ex a e i o ial laws enabling p osecu ion o ci izens o esiden s who ake gi ls
ab oad o FGM. The UK, F ance, and Sweden a e no able o aking legal ac ion agains FGM wi hin immig an
communi ies [20]. S ill, p osecu ions a e a e, and p e en ion emains a p io i y o e punishmen .
E ec i e policy in e en ions equi e a mul i-sec o al app oach ha includes educa ion, communi y sensi iza ion, and
heal hca e suppo alongside legal mechanisms. In eg a ing an i-FGM educa ion in o school cu icula, aining on line
heal h wo ke s, and c ea ing anonymous epo ing channels a e c ucial o b idging he gap be ween legisla ion and
meaning ul impac [21].
3. Medical and Ana omical Consequences o FGM
3.1. O e iew o FGM Classi ica ions and Su gical Me hods
FGM is medically classi ied in o ou ypes, each associa ed wi h a ying deg ees o ana omical al e a ion and heal h
isk. Type I, also known as cli o idec omy, in ol es he pa ial o comple e emo al o he cli o is and/o he p epuce.
This is he leas ex ensi e o m bu s ill esul s in pain, bleeding, and long- e m dys unc ion [22].
Type II, o excision, includes pa ial o o al emo al o he cli o is and he labia mino a, wi h o wi hou excision o he
labia majo a. This ype is mo e in asi e han Type I and is commonly p ac iced in se e al A ican and Middle Eas e n
coun ies [23].
Type III, e e ed o as in ibula ion, is he mos se e e. I in ol es na owing o he aginal o i ice by cu ing and
eposi ioning he labia mino a o labia majo a, some imes accompanied by cli o al emo al. A small opening is le o
u ine and mens ual low, and he aginal opening is o en cu open a ma iage o childbi h [24].
Type IV includes all o he non-medical modi ica ions such as p icking, pie cing, sc aping, o cau e izing he geni al a ea.
Al hough o en pe cei ed as “mino ,” Type IV s ill poses signi ican medical and psychological isks [25].
The ools used a e equen ly non-s e ile, including azo blades, kni es, o b oken glass, and p ocedu es a e ypically
conduc ed wi hou anes hesia by adi ional p ac i ione s. Unde s anding hese classi ica ions is c i ical o clinical
diagnosis, pa ien ca e, and designing app op ia e in e en ion s a egies [26].
3.2. Sho -Te m Medical Complica ions
FGM can lead o a ange o immedia e medical complica ions, many o which a e li e- h ea ening. Se e e pain is
uni e sal due o he lack o anes hesia, o en causing auma and shock. The pain esponse is heigh ened by he
udimen a y ools used and he absence o an isep ic measu es [27].
Hemo hage is a majo conce n, especially in Type II and III p ocedu es whe e ex ensi e issue is excised. Excessi e
bleeding can esul in hypo olemic shock, equi ing eme gency in e en ion—una ailable in many u al se ings [28].
In ec ion is ano he equen complica ion. The use o uns e ilized ins umen s in oduces bac e ia ha can cause
e anus, sepsis, and localized abscesses, o en p og essing o sys emic illness [29].
U ina y e en ion is also common due o swelling, in lamma ion, o he ea o u ina ing h ough a pain ul wound. This
can lead o u ina y ac in ec ions (UTIs), which a e ecu en in many su i o s. Fe e , omi ing, and acu e geni al
auma may ollow, pa icula ly among younge gi ls wi h lowe body mass and immune capaci y [30].
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In a e bu c i ical cases, gi ls die om uncon olled bleeding o sepsis. These ou comes o en go un eco ded due o
social silence, mis epo ing, o bu ial cus oms ha conceal he cause o dea h. The psychological a e ma h begins
immedia ely, wi h gi ls expe iencing ea , con usion, and dissocia ion om hei bodies [31].
Due o he s igma and sec ecy su ounding FGM, many gi ls ecei e no ollow-up ca e. Ea ly complica ions can p og ess
o long- e m heal h issues i un ea ed, including ch onic in ec ions and mens ual p oblems. The sho - e m isks o
FGM hus unde sco e he u gency o p e en i e s a egies and ea ly clinical in e en ion [32].
3.3. Long-Te m Physical and Ana omical Sequelae
Su i o s o FGM ace a li e ime o physical complica ions ha signi ican ly impac hei sexual, ep oduc i e, and
o e all heal h. Vul a damage and sca ing a e among he mos common ou comes, wi h ex ensi e ib osis leading o
pain ul in e cou se (dyspa eunia), na owed aginal openings, and educed sexual sensa ion [33]. In Type III
in ibula ion, he aginal o i ice is o en so cons ic ed ha mens ua ion and u ina ion become pain ul and p olonged,
inc easing he isk o in ec ions and ep oduc i e ac damage.
Neu oma o ma ion, esul ing om se e ed ne e endings du ing cli o al excision, can cause ch onic pain and
hype sensi i i y. This discom o pe sis s h oughou li e and is o en misunde s ood by bo h pa ien s and clinicians
un amilia wi h FGM-speci ic pa hologies [34].
Mens ual complica ions, including dysmeno hea and hema ocolpos, occu when blood low is obs uc ed by sca
issue. These issues can esul in abdominal swelling, anemia, and in some cases, equi e su gical co ec ion. Obs e ic
isks a e pa icula ly conce ning. Women wi h FGM a e signi ican ly mo e likely o expe ience obs uc ed labo ,
pe ineal ea ing, pos pa um hemo hage, and he need o cesa ean sec ions [35].
U ina y and aginal in ec ions a e ecu en due o poo d ainage and al e ed ana omy. The absence o no mal geni al
s uc u es also a ec s lub ica ion, leading o inc eased ic ion and issue ea ing du ing in e cou se, which may
p edispose su i o s o HIV and o he sexually ansmi ed in ec ions [36].
The ana omical damage is o en compounded by psychological auma. Many women associa e hei geni al pain wi h
shame and sec ecy, leading o body image issues and a oidance o in ima e ela ionships. This compounded auma
con ibu es o anxie y, dep ession, and sexual dys unc ion, o en in silence due o ea o s igma iza ion [37].
Recognizing hese long- e m sequelae is c i ical o de eloping auma-in o med ca e and ailo ed su gical o
psychosexual in e en ions. In e disciplina y heal hca e eams mus be ained o iden i y and add ess FGM- ela ed
complica ions ac oss he pa ien ’s li espan o p omo e healing and es o e digni y [38].
Figu e 2 Illus a ion o geni al al e a ions by FGM ype
This igu e p o ides a isual compa ison be ween a no mal emale geni al ana omy and he al e a ions associa ed wi h
Female Geni al Mu ila ion (FGM) Types I, II, and III as classi ied by he Wo ld Heal h O ganiza ion (WHO):
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(02), 2930-2949
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• No mal Ana omy: This illus a ion shows he unal e ed emale geni alia, including he cli o is, u e h al
opening, labia mino a, labia majo a, and aginal o i ice, demons a ing na u al ana omical o ien a ion om
an e io o pos e io .
• FGM Type I (Cli o idec omy): This ype in ol es pa ial o o al emo al o he cli o al glans and/o he p epuce
(cli o al hood).
o Type Ia: Remo al o he p epuce only.
o Type Ib: Remo al o he p epuce and he glans o he cli o is, ei he pa ially o o ally.
• FGM Type II (Excision): In his mo e ex ensi e o m, he e is pa ial o o al emo al o he cli o is and he labia
mino a, wi h o wi hou excision o he labia majo a. This esul s in a b oade ange o issue loss compa ed o
Type I and signi ican ly impac s sexual sensa ion and ana omical in eg i y.
• FGM Type III (In ibula ion): This mos se e e o m in ol es he emo al o pa o all o he labia mino a, and
he labia majo a a e hen sewn oge he o na ow he aginal opening. A small opening is le o u ine and
mens ual blood o pass h ough. This closu e can lead o ch onic pain, in ec ions, and se e e obs e ic
complica ions unless su gically e e sed (de ibula ion).
4. Impac o FGM on sexual unc ion and expe ience
4.1. Neu oana omical Dis up ion and Senso y Loss
Female Geni al Mu ila ion (FGM), pa icula ly Types I and II, in ol es he excision o he cli o is and su ounding issue,
which esul s in signi ican neu oana omical dis up ion. The cli o is con ains o e 8,000 ne e endings—mo e han any
o he pa o he human ana omy—making i cen al o emale sexual a ousal and pleasu e [39]. When hese ne e
endings a e se e ed, he e is no only a physical loss o sensa ion bu also pe manen damage o he pudendal ne e
and associa ed senso y pa hways, impeding neu al ansmission o sexual s imuli.
The do sal ne e o he cli o is, which plays a majo ole in senso y pe cep ion, is equen ly inju ed o des oyed du ing
he cu ing p ocess [40]. This damage signi ican ly educes he abili y o pe cei e ac ile s imula ion, leading o
ano gasmia and gene al loss o sexual sensa ion. In many women, his senso y loss is i e e sible, e en when su gical
in e en ions a emp o econs uc he cli o al a ea [41].
Addi ionally, sca issue o ma ion o e damaged ne e endings may c ea e neu omas, causing ch onic pain o
hype sensi i i y. This condi ion is o en misin e p e ed o un ea ed due o limi ed awa eness among heal hca e
p o ide s. Neu oimaging s udies also sugges ha geni al cu ing may lead o eo ganiza ion in b ain egions
esponsible o p ocessing sexual pleasu e, al hough u he esea ch is needed o subs an ia e hese indings [42].
The ex en o senso y loss depends on he ype and ex en o FGM, he age a which i was pe o med, and he skill o
he p ac i ione . Rega dless, he p ocedu e in a iably esul s in pa ial o comple e elimina ion o he s uc u es
necessa y o sexual senso y pe cep ion. Unde s anding hese neu ological consequences is c ucial o in o ming
clinical assessmen s, de eloping in e en ions, and alida ing su i o s ’expe iences o long- e m dys unc ion [43].
4.2. Sexual Dys unc ion and Dyspa eunia
Sexual dys unc ion is among he mos epo ed consequences o FGM, wi h dyspa eunia (pain du ing in e cou se)
cons i u ing a p e alen symp om ac oss all o ms o geni al cu ing. The emo al o al e a ion o geni al issues—
pa icula ly he cli o is, labia mino a, and aginal opening—leads o ana omical changes ha impai sexual ac i i y and
pleasu e [44]. Women wi h in ibula ion (Type III) o en expe ience na owed aginal in oi us, which makes
pene a ion pain ul o mechanically di icul , o en necessi a ing de ibula ion su ge y p io o sexual in e cou se o
childbi h [45].
In addi ion o physical al e a ions, he sca ing and igidi y o emaining issue educe elas ici y and lub ica ion,
inc easing he isk o issue ea s and u he pain du ing in e cou se. The educ ion in lub ica ion is pa ly due o he
emo al o glands ha con ibu e o aginal mois ening and pa ly due o au onomic ne ous sys em supp ession
caused by emo ional dis ess o auma ecall du ing in imacy [46]. Ho monal in luences—such as s ess-induced
co isol ele a ion—may u he supp ess a ousal mechanisms, exace ba ing d yness and pain [47].
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Psychological ac o s also play a majo ole in sexual dys unc ion pos -FGM. Many women epo eelings o shame, ea ,
o emo ional disconnec ion om hei geni als, which a ec libido and sexual ecep i i y. Cul u al silence a ound
sexuali y can in ensi y his disconnec ion, making i di icul o seek help o discuss symp oms wi h heal hca e p o ide s
o pa ne s [48].
S udies indica e ha he p e alence o sexual dys unc ion among women wi h FGM anges om 60% o 80%, depending
on he popula ion and assessmen c i e ia used [49]. Many women adap o hese changes by limi ing sexual ac i i y o
endu ing pain in silence, o en d i en by social obliga ions a ound ma iage and p oc ea ion.
E ec i e in e en ion equi es bo h medical and psychosexual suppo , including physical ehabili a ion, lub ica ion
aids, auma counseling, and sexual educa ion. Mul idisciplina y ca e eams ha add ess bo h physical and emo ional
dimensions o dyspa eunia a e essen ial o imp o ing sexual well-being among su i o s [50].
4.3. O gasmic Diso de s and Ano gasmia
One o he mos de as a ing consequences o FGM is he de elopmen o o gasmic diso de s, pa icula ly ano gasmia—
he inabili y o achie e o gasm despi e adequa e s imula ion and a ousal. O gasmic diso de s a e especially p e alen
among women who ha e unde gone Types I and II FGM, whe e pa ial o o al cli o idec omy is common [51]. The
cli o is is a c i ical o gan o o gasm due o i s high concen a ion o ne e endings and i s ole in he emale sexual
esponse cycle.
When he cli o is is emo ed o ex ensi ely damaged, he neu al ci cui s in ol ed in gene a ing and p ocessing sexual
pleasu e a e dis up ed. E en in cases whe e some cli o al issue emains, su ounding ib osis, al e ed blood low, and
comp omised ne e endings educe he in ensi y and likelihood o o gasmic esponse [52]. Addi ionally, ana omical
ba ie s, such as sca issue o al e ed ul a geome y, can obs uc s imula ion o e ogenous zones.
Psychological con ibu o s also exace ba e o gasmic di icul ies. Su i o s o FGM may associa e sex wi h pain o
iola ion, c ea ing men al blocks ha inhibi elaxa ion and pleasu e. Mo eo e , a lack o sexual educa ion in many
p ac icing communi ies p e en s women om unde s anding hei bodies o seeking sexual ul ilmen , ein o cing
belie s ha emale pleasu e is unnecessa y o immo al [53].
P e alence s udies ac oss FGM-p ac icing coun ies show ha 40% o 70% o cu women epo di icul ies achie ing
o gasm. In Wes e n diaspo a popula ions, he a es emain high despi e access o mo e libe al sexual en i onmen s,
indica ing ha physical damage is no he only de e minan —cul u al, emo ional, and ela ional ac o s also play
signi ican oles [54].
Medical in e en ions, such as cli o al econs uc ion su ge y, ha e shown some success in es o ing sexual sensa ion
and o gasmic unc ion. Howe e , ou comes a y and depend hea ily on he ex en o o iginal damage, he iming o he
p ocedu e, and pos ope a i e psychosexual suppo [31]. The apy combining su gical, emo ional, and educa ional
componen s emains he mos e ec i e pa hway o add essing FGM- ela ed o gasmic diso de s.
4.4. Psychosexual Sequelae and In imacy Issues
Beyond physical complica ions, FGM has p o ound psychosexual consequences ha a ec in imacy, body image, and
pe sonal iden i y. Many su i o s epo a diminished sense o sexual sel -wo h and an al e ed pe cep ion o eminini y
ollowing he p ocedu e. This dis up ion s ems no only om he loss o e ogenous issue bu also om he symbolic
iola ion o hei bodily au onomy [32].
The i ualis ic aming o FGM—o en accompanied by sec ecy, coe cion, o celeb a ion—can c ea e deep psychological
con lic , pa icula ly when gi ls g ow olde and unde s and he ull implica ions o wha was done o hem. Feelings o
be ayal, loss, and powe lessness a e common, especially when us ed amily membe s acili a ed he ac [33]. These
expe iences con ibu e o long- e m emo ional dis ess, including dep ession, anxie y, and pos - auma ic s ess
diso de (PTSD).
Sexual encoun e s o en igge emo ional lashbacks, causing women o dissocia e o a oid in imacy al oge he . The
ea o pain, judgmen , o ailu e can inhibi a ousal and closeness, c ea ing ension in in ima e ela ionships. Some
women de elop a e sion o sexual ac i i y en i ely, while o he s pa icipa e ou o obliga ion, supp essing hei
discom o o ul il ma i al o ep oduc i e expec a ions [34].
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FGM can also in e e e wi h ela ionship dynamics. Pa ne s may be unawa e o he auma o lack he language o
discuss sexual di icul ies, leading o misunde s andings and emo ional dis ancing. In ce ain cases, FGM can con ibu e
o ma i al con lic , in ideli y, o e en gende -based iolence, pa icula ly when male pa ne s expec sexual
pe o mance wi hou unde s anding he limi a ions imposed by cu ing [35].
Add essing hese sequelae equi es auma-in o med ca e ha espec s cul u al sensi i i y while p io i izing
su i o s ’au onomy and well-being. Psychosexual counselling, pee suppo g oups, and su i o -led educa ion
ini ia i es a e essen ial ools in he healing p ocess. Ul ima ely, es o ing in imacy and sel -con idence o FGM
su i o s in ol es no only physical eco e y bu also he eclama ion o hei iden i y, sexuali y, and pe sonal agency
[36].
Table 2 Summa y o Repo ed Sexual Dys unc ions by FGM Type
FGM
Type
Ana omical Al e a ion
Common Sexual
Dys unc ions
P e alence
Es ima es
Clinical Obse a ions
Type I
Pa ial/ o al emo al o
cli o is and/o p epuce
Reduced sexual desi e,
dec eased cli o al sensa ion,
delayed o gasm
50%–70%
Mode a e loss o e ogenous
s imula ion
Type II
Remo al o cli o is and
labia mino a (± labia
majo a)
Dyspa eunia, ano gasmia,
educed lub ica ion, sexual
a e sion
60%–85%
G ea e ne e damage,
inc eased emo ional
auma
Type
III
In ibula ion: emo al o
cli o is and labia,
na owing o agina
Se e e dyspa eunia,
ano gasmia, pene a ion
di icul ies, low libido
75%–95%
Mos es ic i e; o en
equi es de ibula ion o
in e cou se
Type
IV
P icking, pie cing,
cau e iza ion, o sc aping
Va iable: sexual anxie y,
ea , occasional dyspa eunia
Unknown; ewe
s udies a ailable
Psychological auma o en
signi ican despi e minimal
cu ing
Figu e 3 G aph o sexual heal h ou comes ac oss di e en FGM ypes
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A well- unc ioning eam ensu es ha su i o s ecei e coo dina ed and con inuous ca e, beginning wi h needs
assessmen s and ex ending o ollow-up and communi y ein eg a ion. Fo example, gynaecologis s and su geons
handle de ibula ion o econs uc ion, while psycho he apis s add ess auma, and social wo ke s assis wi h legal,
housing, o immig a ion conce ns. Midwi es and nu ses play a key ole in ep oduc i e counselling and childbi h
planning, ensu ing ha su i o s ecei e cul u ally compe en p ena al ca e and espec ul deli e y se ices [35].
Collabo a ion among disciplines enhances ca e quali y, educes gaps in se ice deli e y, and suppo s comp ehensi e
healing. Regula case e iews, sha ed elec onic heal h eco ds, and pa ien na iga o s help main ain alignmen and
accoun abili y ac oss he ca e con inuum. Mul idisciplina y eams also suppo ad ocacy, esea ch, and aining
ini ia i es o imp o e sys em-wide esponses o FGM.
Ul ima ely, his in eg a ed app oach no only add esses immedia e clinical needs bu also p omo es long- e m
esilience, digni y, and empowe men o su i o s na iga ing he a e ma h o FGM [36].
9. S a egies o p e en ion and global heal h ad ocacy
9.1. Communi y Educa ion and Empowe men
Sus ainable e adica ion o Female Geni al Mu ila ion (FGM) equi es communi y-cen e ed educa ion and
empowe men ini ia i es ha con on deeply oo ed belie s while p omo ing in o med decision-making. Educa ion
p og ams a ge ing pa en s, adolescen s, and ca egi e s can shi a i udes by highligh ing he heal h isks and human
igh s iola ions associa ed wi h FGM [30]. In e ac i e wo kshops, school-based cu icula, and mul imedia campaigns
ha use local languages and cul u ally ele an na a i es ha e p o en e ec i e in changing pe cep ions.
C ucially, hese ini ia i es mus mo e beyond awa eness o os e empowe men , especially among women and gi ls.
P og ams ha p omo e gi ls ’educa ion, delay ma iage, and suppo economic independence inc ease he likelihood
ha hey will esis FGM and ad oca e o o he s in hei communi y [31]. Empowe men also in ol es c ea ing sa e
spaces o dialogue, s o y elling, and pee suppo , whe e su i o s and a - isk indi iduals can sha e expe iences
wi hou ea o judgmen o e alia ion.
E idence om success ul in e en ions in coun ies like Senegal and E hiopia shows ha when communi ies a e
ac i ely in ol ed in designing and deli e ing educa ion campaigns, abandonmen o FGM becomes mo e sus ainable
[32]. These g ass oo s app oaches a e mos impac ul when combined wi h access o heal hca e, counselling, and legal
p o ec ion, ein o cing he message ha abandoning FGM is bo h sa e and socially accep able.
9.2. Engagemen o Religious and T adi ional Leade s
Religious and adi ional leade s hold signi ican in luence in many FGM-p ac icing communi ies and a e he e o e
essen ial allies in he igh agains he p ac ice. Misconcep ions ha FGM is a eligious obliga ion a e widesp ead,
despi e he absence o sc ip u al jus i ica ion in bo h Islam and Ch is iani y [33]. Engaging ai h leade s o publicly
denounce FGM helps o dispel hese my hs and eassu es ollowe s ha abandoning he p ac ice does no con lic wi h
spi i ual belie s.
T adi ional leade s, including elde s, chie s, and ci cumcise s, also shape cul u al no ms and p ac ices. In ol ing hem
in dialogue and al e na i e i es o passage p og ams has been success ul in ein e p e ing adi ion wi hou
pe pe ua ing ha m [34]. Communi y decla a ions made in pa ne ship wi h hese leade s ca y signi ican weigh and
can ca alyze collec i e abandonmen .
Impo an ly, engagemen e o s mus be amed as collabo a i e and espec ul, a he han accusa o y o ex e nal.
Leade s a e mo e likely o pa icipa e when hey a e included in solu ion-building, acknowledged o hei au ho i y,
and equipped wi h accu a e heal h in o ma ion and heological guidance [35]. Success ul p og ams o en p o ide
capaci y-building o leade s, empowe ing hem o ac as champions o change wi hin hei own communi ies.
This app oach no only accele a es beha iou al change bu also lends legi imacy o an i-FGM e o s, os e ing us and
coope a ion a he g ass oo s le el.
9.3. Policy Ad ocacy, Law En o cemen , and Global Coali ions
Policy e o m, legal en o cemen , and in e na ional collabo a ion a e in eg al o he global s a egy o elimina ing FGM.
Na ional legisla ion c iminalizing FGM exis s in o e 30 coun ies, ye en o cemen emains inconsis en due o
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co up ion, limi ed esou ces, and social esis ance [36]. Ad ocacy e o s a e essen ial o s eng hen legal amewo ks,
ensu e p o ec ion o a - isk gi ls, and hold pe pe a o s accoun able h ough ai and anspa en judicial sys ems.
Global coali ions—led by o ganiza ions such as UNFPA, UNICEF, and he Wo ld Heal h O ganiza ion (WHO)—ha e
uni ed s akeholde s h ough mul i-sec o al ini ia i es like he Join P og amme on he Elimina ion o FGM. These
coali ions suppo na ional go e nmen s by unding educa ion, heal hca e in as uc u e, legal e o m, and da a
collec ion o moni o p og ess [37].
In e na ional ins umen s such as he Con en ion on he Righ s o he Child, CEDAW, and he Sus ainable De elopmen
Goals (Ta ge 5.3) p o ide he no ma i e basis o global ac ion. Policy ad ocacy should align na ional s a egies wi h
hese in e na ional obliga ions, encou aging go e nmen s o implemen c oss-cu ing in e en ions ha span heal h,
educa ion, and jus ice sec o s [38].
Fu he mo e, ci il socie y o ganiza ions play a c i ical ole in moni o ing implemen a ion, engaging communi ies, and
holding s a es accoun able. When suppo ed by s ong legal amewo ks and in e na ional coope a ion, policy ad ocacy
becomes a powe ul d i e o las ing change in he global igh o end FGM.
10. Conclusion and u u e di ec ions
10.1. Key Findings and In e disciplina y Implica ions
This pape has c i ically examined he mul i ace ed impac o Female Geni al Mu ila ion (FGM), emphasizing i s
de as a ing consequences on sexual heal h, psychological well-being, ep oduc i e ou comes, and ela ional dynamics.
The e idence demons a es ha FGM leads o a wide ange o ch onic physical and psychosexual dys unc ions, including
pain du ing in e cou se, ano gasmia, in ec ions, in e ili y, and auma-induced a e sion o in imacy. Beyond i s
physiological oll, FGM unde mines women's au onomy, sel -pe cep ion, and access o equi able heal hca e.
A cen al inding is he need o in e disciplina y collabo a ion in managing FGM- ela ed ou comes. E ec i e ca e
equi es in eg a ion o medical, su gical, psychological, and social se ices ailo ed o he su i o 's speci ic ype o
cu ing, cul u al backg ound, and li ed expe ience. Gynaecologis s, psycho he apis s, social wo ke s, communi y heal h
educa o s, and policy ad oca es mus wo k oge he o ensu e ha clinical in e en ions a e pai ed wi h auma-
in o med he apy, legal p o ec ion, and cul u ally esponsi e ou each.
Mo eo e , p e en ion and e adica ion s a egies a e mos success ul when oo ed in communi y engagemen and
suppo ed by eligious and adi ional leade s. Global heal h coali ions, legal ins i u ions, and g ass oo s mo emen s
mus ope a e in unison o disman le ha m ul no ms and uphold he igh s o women and gi ls. FGM is no only a medical
o legal issue—i is a deeply social, emo ional, and e hical challenge ha demands holis ic, in e disciplina y esponses.
10.2. Recommenda ions o Resea ch, Policy, and Clinical P ac ice
To enhance su i o suppo and accele a e he e adica ion o FGM, u u e e o s should p io i ize su i o -cen e ed
esea ch ha cap u es long- e m physical, psychological, and sexual heal h ou comes ac oss di e se cul u al se ings.
Rigo ous, longi udinal s udies a e needed o e alua e he e ec i eness o su gical and he apeu ic in e en ions,
including cli o al econs uc ion and auma-in o med psychosexual he apy.
On he policy on , na ional go e nmen s should s eng hen legal en o cemen mechanisms while expanding access o
educa ion and social p o ec ion o gi ls a isk. Policies mus b idge he gap be ween legisla ion and p ac ice by
in es ing in capaci y-building o on line wo ke s and communi y leade s. Legal e o ms should also include
p o isions o con iden ial epo ing and sa e shel e s o su i o s and a - isk indi iduals.
Clinically, all heal h p o essionals should ecei e aining on iden i ying and managing FGM- ela ed complica ions using
cul u ally sensi i e and pa ien -cen e ed app oaches. Mul idisciplina y eams mus be embedded in o heal h sys ems
o ensu e seamless coo dina ion be ween su gical ca e, counseling se ices, ep oduc i e heal h, and ad ocacy suppo .
Ul ima ely, he e adica ion o FGM and he healing o su i o s equi e a uni ed e o ac oss disciplines—blending
science, compassion, policy, and g ass oo s empowe men o uphold digni y, es o e heal h, and p o ec u u e
gene a ions om ha m.
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